Healthy Skepticism Library item: 2984

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: news

Branswell H.
CMA faces censorship confrontation
The Globe and Mail ( Canada) 2005 Dec 12
http://www.theglobeandmail.com/servlet/story/RTGAM.20051212.wcma1212/BNStory/National/

Keywords:
CMAJ CMA

Notes:

Ralph Faggotter’s Comments:

There has been considerable controversy in Canada about how ‘Plan B’ (the morning-after-pill) should be made available to the women requesting it.

Interestingly, during the course of this debate, the CMA (Canadian Medical Association) which owns the CMAJ ( Canadian Medical Association Journal) chose to prevent a piece of investigative journalism from being published in the CMAJ.

See article- “ Mr. Hoey said the Canadian Pharmacists Association learned of the article before it went to press. The association complained to the Canadian Medical Association, which in turn told the journal it could not publish the material gathered by the women who attempted to purchase the drug.”

This episode raises questions about the editorial independence of serious medical jorunals, especially when they are owned by political organisations like the CMA, and adds further to a growing sense of uncertainty about the accuracy and objectivity of information to be found in even the most prestigious of medical journals.
See also-

HSL3415
Mathews A.
Ghost Story – At Medical Journals, Writers Paid by Industry Play Big Role
THE WALL STREET JOURNAL 2005 Dec 13
http://online.wsj.com/article/SB113443606745420770.html

and-

HSL3291
Langreth L, Herper M.
Merck’s Deleted Data
Forbes.com 2005 Dec 8
Link to source with long URL

Full text:

CMA faces censorship confrontation

By HELEN BRANSWELL

Monday, December 12, 2005 Posted at 6:55 PM EST

Canadian Press

Toronto – The Canadian Medical Association Journal has charged its owner, the Canadian Medical Association, with interfering with the editorial independence of the journal over a news report on the way pharmacies were handling sales of Plan B, the so-called morning-after pill.

In an editorial slated for the Jan. 3 issue but released on-line Monday, journal editor John Hoey announced he has struck a blue-ribbon panel to draw a clear line for the CMA on the issue of editorial autonomy.

“That interface between us, the journal, and the owners needs to be fortified and strengthened and understood, I think, by the CMA,” Mr. Hoey said in an interview.

“We’re trying to be a reputable journal.”

The panel will be chaired by Jerome Kassirer, former editor-in-chief of the New England Journal of Medicine. Other members are Donald Redelmeier, a medical professor at the University of Toronto; and Frank Davidoff, editor emeritus of the Annals of Internal Medicine.

André Picard, the Globe and Mail’s health reporter, was initially named to the panel. But late Monday, Mr. Picard said in an e-mail that he had resigned because participation could put him in a conflict of interest situation.

Officials of the Canadian Medical Association were not immediately available for comment.

The conflict stems from a piece of investigative reporting by the news staff of the journal on the information pharmacists around the country were demanding of women asking to purchase levonorgestrel, sold under the brand name Plan B.

Since earlier this year the drug, once available through prescription only, has been sold on a behind-the-counter basis, meaning women can get it from a pharmacist without a prescription. The goal was to improve access to the drug, which must be taken within 72 hours of intercourse to prevent pregnancy.

The journal asked a woman in each province and territory to try to buy the drug. A number reported pharmacists demanded and entered into a computer database personal information such as the woman’s name and address.

That is not common practice for sale of other behind-the-counter drugs, such as cold or sinus medications containing codeine.

Mr. Hoey said the Canadian Pharmacists Association learned of the article before it went to press. The association complained to the Canadian Medical Association, which in turn told the journal it could not publish the material gathered by the women who attempted to purchase the drug.

“It’s the first time they’ve actually censored something,” said Mr. Hoey, who has had a number of run-ins with the CMA over the decade he’s edited the journal.

The journal dropped the material from its informal survey but did publish an article on the practice of gathering personal information from people attempting to buy the drug.

In the wake of publication, pharmacists in Ontario have been asked to stop collecting the data after the province’s privacy commissioner complained about the practice.

Mr. Hoey said sporadic tensions between the journal and the association often stem from misunderstandings on the part of CMA board members about the meaning of editorial independence.

“They understand that this is a journal and independent. But independence for them has limits – which then castrates the meaning of independence.”

Latest Comments in the Conversation

Editor’s Note: Globeandmail.com editors read and approve each comment. Comments are checked for content only, spelling and grammar errors are not corrected and comments that include vulgar language or libelous content are rejected.

1. Raymond Ha from Canada writes: In light of gender sensitivity and political correctness, objectivity is often lost in heated issues such as the provision of emergency contraceptive (ECP). First of all, however, in response to the charge by the CMAJ to the CMA, I support the former’s position in editorial autonomy provided the findings are evidence-based (i.e. non-biased). Let’s use common sense to look at the ECP issue: any woman seeking ECP at a pharmacy has made a decision of preventing pregnancy after unprotected sex. Since being pregnant would have an immense impact in her life, the pharmacist has the professional responsibility to ensure the proper and effective use of ECP. It is therefore inevitable for him/her to first gather pertinent information before making a recommendation in order to minimize complications such as drug allergy and overdue in treatment. During info collection, (s)he may also be able to detect certain potential issues leading to further referral such as the need of regular birth control method or rarely, sexual assault. The collection of address and phone no. at physician’s office has never been an issue when ECP is prescribed by an MD. So why does a pharmacy, also a professional premise, cause such controversy? The info obtained, whether electronically stored or not, is kept strictly confidential per PIPEDA requirement. The example posted previously about a pharmacist pressuring a repeat ECP user via computer record is plain alarmism. What would the sentiment be if “Pharmacist” is replaced by “Doctor”? Pharmacists in Ontario,for instance,have access to standard protocol developed by CPhA in ECP counselling. Most have been trained to provide the service. If a woman is uncomfortable with a male pharmacist, she can ask for a female one when available. Autonomy is no doubt important, but it is also imperative to know the fact first * Posted Dec. 13, 2005 at 4:22 AM EST * Link to Comment 2. Billy Germo from Helsinki, Finland writes: With all due respect, I must agree with everyone that Mr. Simpson’s argument sounds like something Mr. Homer Simpson might put forward. Collecting a 16 year old girl’s information on a computer database could in no way protect her or help her understand how Plan B! On the contrary, If a 16 yr old girl knows that her name and information will be logged onto a computer, it might deter her from purchasing the drug, adding to the number of teenage single mothers. * Posted Dec. 13, 2005 at 4:57 AM EST * Link to Comment 3. Ginny Cameron from Hamilton, Canada writes: This is fraught with issues regarding the information obtained. Why? Was it requested by the pharmaceutical company in case there are health issues for these women. Who? Government or Drug Manufacturer? A prior study by the drug maker must have been done to ascertain how effective the medication is. How many people know this medication is available? Reward? Were the pharmacies involved being paid for the gathering of the information? Will Health Canada weigh in on this? * Posted Dec. 13, 2005 at 7:14 AM EST * Link to Comment 4. Geoff Eby from Toronto, Canada writes: I have requested over-the-counter medication dozens of times and the procedure is always the same: they ask me if I’ve ever taken it before, they go over side effects and dosage and then they ask cash or credit. At no time has anyone ever asked for my name and address to request an over-the-counter medication EXCEPT to add me to their customer database, which has nothing at all to do with continuity of patient care… except in the eyes of their marketing department. I have seen a lot of indignation from defenders of pharmacists, but I have yet to see anyone give a viable reason why this specific over-the-counter medication would require customer information to be provided…. and please note I said customer.Pharmacists are not, by any stretch of the imagination, physicians and their customers are not their patients despite the marketing campaigns by the various major pharmaceutical chains. I can only conclude that it is the stigma being attached to the product itself which motivates pharmacists to track its sale and the customers who purchase it.Perhaps anyone who buys the drug will get a flyer in the mail featuring sale coupons for condoms?Whatever qualifications a pharmacist may possess, drug stores are retails outlets, driven by profit and market share.To suggest that they collect information not specifically required by government regulations out of the goodness of their hearts is, at best, a leap of faith over a very deep chasm. * Posted Dec. 13, 2005 at 9:25 AM EST * Link to Comment 5. A Thorp from Ottawa, Canada writes: I think the larger issue is more the fact that it is the discrepancy in the collection of information. If this was for ‘continuity of care’ then the information would be recorded for all over-the-counter products, not only Plan B. Which leaves us with the question: Why are pharmacies collecting the information? * Posted Dec. 13, 2005 at 12:37 PM EST * Link to Comment